Nuchal translucency, ductus venosus and congenital heart disease: an important association – a cautious analysis

Carvalho, J. S.

doi:10.1046/j.1469-0705.1999.14050302.x

Cited by 25 publications

(18 citation statements)

References 44 publications

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“…Several studies have been carried out in this field, but we are far from agreeing on the results [28][29][30]. The first-trimester Doppler study of the fetal venous compartment is not easy, not only because of technical problems (the fetus in its entirety is very small and the vessels are very narrow) but also ethical ones, due to the uncertainty about the safety of the Doppler technique for younger fetuses.…”

Section: Discussionmentioning

confidence: 91%

First-Trimester Ductus venosus Velocimetry in Relation to Nuchal Translucency Thickness and Fetal Karyotype

et al. 2002

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Aim: To evaluate first-trimester ductus venosus flow in relation to nuchal translucency (NT) and fetal karyotype. Methods: Ductus venosus flow was measured in fetuses with NT greater than or equal to the 95th centile (group A) and in fetuses with NT less than the 95th centile (group B). The waveforms were classified as normal if the lowest forward velocity during atrial contraction (ACV) was positive and abnormal if it was absent or negative. The results were compared with the fetal karyotype. Results: Ductus venosus measurement was carried out in 330 fetuses. In group A, there were 156 fetuses: in 4 cases, it was not possible to obtain the measurement, and in the other 152 cases, 93 (61%) had a normal ACV and 59 (39%) an abnormal ACV. NT thickness was significantly greater in fetuses with abnormal ACV. In 34 out of 156 cases (22%), chromosomal abnormalities were found. Twenty-three chromosomopathies out of 33 (70%) had an abnormal ACV, and 10 (30%) had a normal ACV. A significant association between abnormal karyotype and abnormal ACV was found. Ductus venosus measurement was carried out in 174 fetuses of group B. In 1 case, it was not possible to obtain the measurement. One hundred and seventy-one (99%) cases had a normal ACV, and in 2 (1%) cases the ACV was abnormal. No chromosomal abnormalities were found in group B. Considering group A and group B, a significant association between the finding of an enlarged NT and abnormal ACV was detected (p < 0.05). Conclusions: An abnormal ACV is more frequent in fetuses presenting enlarged NT than in those having normal NTs and in fetuses having the larger nuchal thickness. The probability of having a chromosomal abnormality in fetuses with enlarged NT is greater when an abnormal ACV is found.

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Section: Discussionmentioning

confidence: 91%

First-Trimester Ductus venosus Velocimetry in Relation to Nuchal Translucency Thickness and Fetal Karyotype

et al. 2002

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“…It has been suggested that either left ventricular outflow tract obstruction or temporarily/persistent cardiac failure might be the causes for the nuchal edema 11,12 . In conotruncal and aortic arch anomalies with and without CATCH 22 syndrome, both pathogenetic mechanisms might be an explanation for the association between increased NT thickness and the cardiac defect.…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of 22q11 microdeletion in an early second‐trimester fetus with conotruncal anomaly presenting with increased nuchal translucency and bilateral intracardiac echogenic foci

Machlitt

Tennstedt

Körner

et al. 2002

Ultrasound in Obstet & Gyne

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“…Flow velocity waveform studies of the vessel in early pregnancy are also possible, both transvaginally and transabdominally [5][6][7][8] . Recent reports have raised interest in ductus venosus Doppler studies at 10-14 weeks of gestation, demonstrating an association between abnormal flow patterns and fetal chromosomal abnormalities 9,10 or congenital cardiac defects 11,12 in high-risk pregnancies. In these studies, increased values of pulsatility index for veins (PIV) and absent or reversed flow during atrial contraction were correlated with abnormal pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of ductus venosus Doppler flow measurements at 11–14 weeks of gestation

Prefumo

Biasio

Venturini

2001

Ultrasound in Obstet & Gyne

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Objectives To assess the intra-and interobserver repeatabilities of fetal ductus venosus Doppler measurements at 11-14 weeks of gestation.Design Flow velocity waveforms were recorded transabdominally. Intraobserver repeatability was studied in 22 fetuses in whom four repeated measurements were performed by the same observer. Interobserver repeatability was assessed in 54 fetuses in each of whom two observers performed two repeated measurements. The pulsatility index for veins (PIV), peak velocity during ventricular systole (S wave), peak velocity during atrial contraction (A wave) and time-averaged maximum velocity (TAMV) were recorded. Reproducibility of the Doppler measurements was analyzed by calculating repeatability coefficient, coefficient of variation (CV), intraclass correlation coefficient (ICC), mean differences and their limits of agreement. Cohen's k-coefficient was used for categorical data.Results Intraobserver repeatability was good with a CV of 10%,13%, 22% and 13% and an ICC of 0.85, 0.94, 0.94 and 0.95, respectively, for PIV, S wave, A wave and TAMV. Interobserver repeatability was also good, and no bias between the observers was detected. A CV of 8.8%,14%, 27% and 15% and an ICC of 0.86, 0.84, 0.87 and 0.84, respectively, for PIV, S wave, A wave

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Nuchal translucency, ductus venosus and congenital heart disease: an important association – a cautious analysis

Cited by 25 publications

References 44 publications

First-Trimester Ductus venosus Velocimetry in Relation to Nuchal Translucency Thickness and Fetal Karyotype

First-Trimester Ductus venosus Velocimetry in Relation to Nuchal Translucency Thickness and Fetal Karyotype

Prenatal diagnosis of 22q11 microdeletion in an early second‐trimester fetus with conotruncal anomaly presenting with increased nuchal translucency and bilateral intracardiac echogenic foci

Reproducibility of ductus venosus Doppler flow measurements at 11–14 weeks of gestation

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